Severe Hypercalcemia as the Presenting Sign of Tuberculosis
Bibliographic record
Abstract
Severe hypercalcemia due to tuberculosis (TB) is rare. We describe a case of a 25-year-old male who was found to have a serum calcium level 15.4 mg/dL at a routine appointment prompting admission. Chest imaging demonstrated hilar lymphadenopathy and airspace opacities principally involving the lingula. Multiple sputum smears were negative for acid-fast bacilli (AFB), but cultures of sputum subsequently grew Mycobacterium tuberculosis . Despite appropriate therapy for TB, his serum calcium failed to normalize, prompting initiation of prednisone with rapid improvement. In granulomatous diseases, including TB, inflammation is mediated in part by elevated calcitriol released from macrophages, with resulting rises in serum calcium concentrations. Glucocorticoids are commonly used as adjunctive therapy for TB meningitis and pericarditis and this case emphasizes the potential role for steroids in refractory hypercalcemia. J Med Cases. 2015;6(8):382-384 doi: http://dx.doi.org/10.14740/jmc2220w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".